What is Cognitive Behavioral Therapy for Insomnia (CBT-i)?

Cognitive behavioral therapy for insomnia (CBT-i) is a technique used to combat insomnia by helping patients get to the root of their sleep issues and learn how to control anti-sleep thoughts, beliefs, and behaviors. 

With the help of a sleep diary and a sleep expert, you first learn to understand the reasons why you’re not sleeping well. Once the root causes have be identified, you can start to work on finding a normal routine by cutting back on daytime naps, going to bed later and/or leaving your bedroom for sleep, reducing meals, caffeine or alcohol late in the day, practicing relaxation techniques, and other environmental and habitual modifications.

Results can be seen after just one session but usually at least four sessions and a detailed sleep diary are ideal.

CBT-i is recommended by sleep experts as first line treatment (or first choice) for insomnia with or without co-existing medical conditions (like depression, anxiety, and PTSD).

CBT-i has no side effects and won’t cause dependency. In fact:

  • The American College of Physicians reports that CBT-i is safer than medications for insomnia.
  • The American Psychological Association (APA) says CBT-i works better than medications. APA also notes that CBT-i can play a helpful role in depression treatment, helps people fall asleep in half the time, and can roll-back or abate insomnia in many cases.
  • Consumer Reports calls cognitive behavioral therapy the “best buy” for insomnia.
  • The AARP adds that benefits can last for years.

So, why don’t we hear more about CBT-i?

One reason may be because CBT-i takes individual effort. For CBT-i to be successful, participants must work on changing behaviors and routines. 

Another reason is that CBT-i can sometimes be hard to access because there aren’t trained, experienced CBT-i providers in every community (yet).

Thankfully, new technologies are helping to solve this problem. By using smartphones and telehealth solutions, CBT-i can be delivered conveniently nearly anywhere — even if the care provider and the insomnia sufferer are hundreds of miles apart.